The DASH (Disabilities of the Arm, Shoulder and Hand) Outcome Measure: What do we know about it now?

2001 ◽  
Vol 6 (4) ◽  
pp. 109-118 ◽  
Author(s):  
Dorcas E Beaton ◽  
Aileen M Davis ◽  
Pamela Hudak ◽  
Sara Mcconnell
Keyword(s):  
Clinical Practice ◽  
Physical Function ◽  
Outcome Measures ◽  
Musculoskeletal System ◽  
Outcome Measure ◽  
Outcome Measurement ◽  
Future Research ◽  
Strength Testing ◽  
Joint Motion ◽  
The Impact

Outcome measurement is an essential component for defining the effectiveness of clinicians’ practice (Reiman 1988) and standardised measures make that job more consistent, comparable and valid (Cole et al 1994). Hand therapists have long recognised the need for the standardisation of outcome measures, particularly for performance-based measures such as strength testing (Mathiowetz et al 1985, Woody et al 1988) or joint motion. More recently there has been an increased interest in outcome measures that capture the patient's perspective of their status, and that are standardised. The DASH (Disabilities of the Arm, Shoulder and Hand) is a standardised outcome measure that could be used for this purpose (Hudak et al 1996, McConnell et al 1999). The DASH reflects the impact of a disorder in terms of physical function and symptoms, which are the two main reasons patients seek care for a disorder of the musculoskeletal system. The DASH is becoming widely used by clinicians and researchers (McConnell et al 1999). It is now important to revisit what we know about how well the DASH is able to measure what it purports to measure. The purpose of this paper is to review the research that has been done to date on the DASH outcome measure, and to describe the implications of this for future research and for clinical practice.

scholarly journals Routine outcome measurement in public mental health: results of a clinician survey

2006 ◽  
Vol 30 (2) ◽  
pp. 164 ◽  
Author(s):  
Tom Callaly ◽  
Mary Hyland ◽  
Tim Coombs ◽  
Tom Trauer
Keyword(s):  
Mental Health ◽  
Clinical Practice ◽  
Outcome Measures ◽  
Outcome Measure ◽  
Health Workers ◽  
Outcome Measurement ◽  
Public Mental Health ◽  
Mental Health Workers ◽  
Clinical Value ◽  
Routine Outcome Measurement

This paper explores the attitudes of mental health workers in one public mental health service towards the implementation and use of routine outcome measurement. Two years after their introduction into routine clinical practice, there were equal numbers of positive and negative observations from clinicians about the clinical value of the clinician-rated outcome measures, while more positive observations were made about value of the consumer-rated outcome measure. The most frequent observation from clinicians in relation to making outcome measures more useful to them in clinical practice was that more training, particularly refresher training, is needed. In addition, clinicians indicated that more sophisticated support which assists them to understand the meaning and possible use of outcome measure ratings is required.

scholarly journals Measuring what matters to patients: Using goal content to inform measure choice and development

2015 ◽  
Vol 22 (2) ◽  
pp. 170-186 ◽  
Author(s):  
Jenna Jacob ◽  
Julian Edbrooke-Childs ◽  
Duncan Law ◽  
Miranda Wolpert
Keyword(s):  
Mental Health ◽  
Young People ◽  
Health Services ◽  
Outcome Measures ◽  
Outcome Measure ◽  
Outcome Measurement ◽  
Comparison Method ◽  
Future Planning ◽  
Children And Young People ◽  
Relevant Outcome

Introduction: Personalised care requires personalised outcomes and ways of feeding back clinically useful information to clinicians and practitioners, but it is not clear how to best personalise outcome measurement and feedback using existing standardised outcome measures. Method: The constant comparison method of grounded theory was used to compare goal themes derived from goals set at the outset of therapy for 180 children aged between 4 and 17 years, visiting eight child and adolescent mental health services, to existing standardised outcome measures used as part of common national datasets. Results: In all, 20 out of 27 goal themes corresponded to items on at least one commonly used outcome measure. Discussion: Consideration of goal themes helped to identify potential relevant outcome measures. However, there were several goal themes that were not captured by items on standardised outcome measures. These seemed to be related to existential factors such as understanding, thinking about oneself and future planning. Conclusion: This presents a powerful framework for how clinicians can use goals to help select a standardised outcome measure (where this is helpful) in addition to the use of a goal-based outcome measure and personalise choices. There may be areas not captured by standardised outcome measures that may be important for children and young people and which may only be currently captured in goal measurement. There is an indication that we may not be measuring what is important to children and young people. We may need to develop or look for new measures that capture these areas.

Appraisal of Candidate Instruments for Assessment of the Physical Function Domain in Patients with Psoriatic Arthritis

2020 ◽  
Vol 48 (1) ◽  
pp. 58-66 ◽  
Author(s):  
Ying Ying Leung ◽  
Ana-Maria Orbai ◽  
Alexis Ogdie ◽  
Pil Hojgaard ◽  
Richard Holland ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Physical Function ◽  
Outcome Measures ◽  
Physical Functioning ◽  
Working Group ◽  
Short Form ◽  
Outcome Measurement ◽  
Patient Reported Outcome Measures ◽  
Measurement Information ◽  
Patient Reported

Objective.Numerous patient-reported outcome measures (PROM) exist for the measurement of physical function for psoriatic arthritis (PsA), but only a few are validated comprehensively. The objective of this project was to prioritize PROM for measuring physical function for potential incorporation into a standardized outcome measurement set for PsA.Methods.A working group of 13 members including 2 patient research partners was formed. PROM measuring physical function in PsA were identified through a systematic literature review and recommendations by the working group. The rationale for inclusion and exclusion from the original list of existing PROM was thoroughly discussed and 2 rounds of Delphi exercises were conducted to achieve consensus.Results.Twelve PROM were reviewed and discussed. Six PROM were prioritized: Health Assessment Questionnaire (HAQ) and 4 modifications (HAQ-Disability Index, HAQ-Spondyloarthritis, modified HAQ, multidimensional HAQ), Medical Outcomes Study 36-item Short Form survey physical functioning domain, and the Patient-Reported Outcomes Measurement Information System (PROMIS) physical functioning module.Conclusion.Through discussion and Delphi exercises, we achieved consensus to prioritize 6 physical function PROM for PsA. These 6 PROM will undergo further appraisal using the Outcome Measures in Rheumatology (OMERACT) Filter 2.1.

scholarly journals The impact of patient-reported outcome measures in clinical practice for pain: a systematic review

2016 ◽  
Vol 26 (2) ◽  
pp. 245-257 ◽  
Author(s):  
Michelle M. Holmes ◽  
George Lewith ◽  
David Newell ◽  
Jonathan Field ◽  
Felicity L. Bishop
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Outcome Measures ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Patient Reported ◽  
The Impact

scholarly journals From outcome measurement to improving health outcomes following lower limb amputation - making outcome measurement work from a clinical practice perspective

2020 ◽  
Author(s):  
Chantel Ostler ◽  
Helen Scott ◽  
Imad Sedki ◽  
Sisary Kheng ◽  
Maggie Donovan-Hall ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Health Outcomes ◽  
Lower Limb ◽  
Care Delivery ◽  
Outcome Measurement ◽  
Narrative Review ◽  
Successful Outcome ◽  
Prosthetic Rehabilitation ◽  
Clinical Narrative ◽  
The Impact

Background: Outcome measurement is essential to understand the impact of clinical interventions and the performance of services. Despite national and professional encouragement outcome measurement has failed to become embedded in clinical practice and its value continues to be questioned. Objectives: To address the outcome measurement debate within lower limb prosthetic rehabilitation and provide a critical synthesis of the evidence surrounding the discussion applied within the clinical context of the UK National Health Service (NHS).Study Design: Narrative review Methods: The authors drew on over 20 years clinical experience in prosthetic rehabilitation to synthesise and critique the outcome literature across a breadth of healthcare services. A narrative review methodology was selected to give voice to the clinical narrative thread.Results: This review addresses why we should measure health outcomes, the health care delivery and organisational scenarios in which outcome measurement can be beneficial and explores where lessons can be learnt for prosthetic rehabilitation from approaches in different specialities. The current outcome measurement literature within prosthetic rehabilitation is critiqued and we discuss the issues facing this field in the future.Conclusions: The dilemma of successful outcome measurement in clinical practice is multifaceted. Understanding and embedding value at every step is key to success. Addressing the questions of `why’, `what’ and `how’ we measure outcome will move us closer to a national consensus. Routine outcome measurement implementation at the clinical level must ensure data collection is valuable to clinical practice, makes use of IT solutions and has all important organisational buy in.

scholarly journals Remote home monitoring (virtual wards) during the COVID-19 pandemic: a living systematic review

2020 ◽  
Author(s):  
Cecilia Vindrola-Padros ◽  
Kelly E Singh ◽  
Manbinder S Sidhu ◽  
Theo Georghiou ◽  
Chris Sherlaw-Johnson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Patient Safety ◽  
Outcome Measures ◽  
Secondary Care ◽  
Meta Analysis ◽  
Eligible Patient ◽  
Home Monitoring ◽  
Healthcare Sector ◽  
Future Research ◽  
The Impact

ABSTRACTObjectivesThe aim of this review was to analyse the implementation and impact of remote home monitoring models (virtual wards) during COVID-19, identifying their main components, processes of implementation, target patient populations, impact on outcomes, costs and lessons learnt. The review will be kept ‘live’ through regular updates.DesignThe review was designed as a living systematic review to capture a rapidly evolving evidence base. We used the Preferred Reporting Items for Systematic Reviews and Meta- Analysis (PRISMA) statement.SettingThe review included remote home monitoring models led by primary and secondary care across seven countries.Participants17 examples of remote home monitoring models were included in the review.Main outcome measuresImpact of remote home monitoring on virtual length of stay, escalation, Emergency department attendance/reattendance, admission/readmission and mortality.ResultsThe primary aim of the remote home monitoring models was the early identification of deterioration for patients self-managing COVID-19 symptoms at home. Most models were led by secondary care. Broad criteria for the eligible patient population were used and confirmation of COVID-19 was not required (in most cases). Monitoring was carried via online platforms, paper-based systems with telephone calls or (less frequently) through wearable sensors. We could not reach conclusions regarding patient safety and the identification of early deterioration due to lack of standardised reporting across articles and missing data. None of the articles reported any form of economic analysis, beyond how the resources were used.ConclusionsThe review pointed to variability in the implementation of the models, in relation to healthcare sector, monitoring approach and selected outcome measures. Lack of standardisation on reporting prevented conclusions on the impact of remote home monitoring on patient safety or early escalation during COVID-19. Future research should focus on staff and patient experiences of care and potential inequalities in patients’ access to these models. Attention needs to be paid to the processes used to implement these models, the evaluation of their impact on patient outcomes through the use of comparators, the use of risk-stratification tools, and cost-effectiveness of the models and their sustainability.Protocol registrationThe review protocol was published on PROSPERO (CRD: 42020202888).

scholarly journals Understanding the Impact of Bipolar Disorder Experience from an Insiders' Perspective

2020 ◽  
pp. 1-5
Author(s):  
Sophie Favre ◽  
Hélène Richard-Lepouriel ◽  
Sophie Favre
Keyword(s):  
Bipolar Disorder ◽  
Clinical Practice ◽  
Lived Experience ◽  
Life Experience ◽  
Single Case ◽  
Real Life ◽  
Future Research ◽  
Type I ◽  
Key Informant ◽  
The Impact

Introduction: Bipolar disorder is characterized by recurrent episodes of depression and hypomania and is often associated with functional impairment even between mood episodes. A substantial proportion of patients experience inter-episode mood swings, making bipolar disorder a complex psychiatric disorder to manage. Patients’ perspectives can enhance clinical practice and research. The present study aimed to explore the impact of the bipolar disorder experience from a patient’s perspective to facilitate better understanding in clinical practice and future research. Method: We conducted a single case study with a key informant living with bipolar disorder (type I) for more than 20 years. The key informant constructed a chart of his mood disorder experiences. Subsequently, he commented on the chart and these comments were noted down by his therapist. Results: We present a chart of lived experience perception by a person living with bipolar disorder. The main axis was reality perception and it was related with mood, identity, and functioning. The comments on the chart provided a detailed and accurate description of a lived experience of functioning of bipolar disorder and its impact on a person’s life. Discussion: Globally, the experiences described by the key informant are consistent with previous literature. The principal finding was the meaning of the subjective experiences of reality perception, their relation with mood change, and impact on the person’s life. The perception of reality seems to be a key factor in the experience of bipolar mood swings. Not only did the disorder affect the self and the functioning, but at its extreme, reality “either did not matter or did not exist.” This feeling enhanced the sense of being disconnected from the world and the surroundings and led to the experience of extreme loneliness. Conclusion: The description in this study cannot be generalized, since it was conducted with only one subject. However, it provided a better insight into the detailed real-life experience that can be useful for clinicians treating persons living with bipolar disorder. Such descriptions obtained from a qualitative procedure can also be combined with quantitative data in patients' assessments and research. This study suggests that the experience of “disconnection” should be investigated further.

scholarly journals 1205. Vaccine Hesitancy in Paediatric Practice and Predictors of Physician-Reported Vaccine Compliance

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S693-S693
Author(s):  
Kate E Allan
Keyword(s):  
Clinical Practice ◽  
Classification Tree ◽  
Vaccine Hesitancy ◽  
Future Research ◽  
Surveillance Program ◽  
Vaccine Preventable Diseases ◽  
University Of Toronto ◽  
Methods Of Evaluation ◽  
Patient Resources ◽  
The Impact

Abstract Background This study explores the frequency with which Canadian paediatricians encounter vaccine hesitancy in their clinical practice, the most common approaches to parent resistance, impact of hesitancy practice and predictors of physician-reported vaccine compliance. Methods This analysis used data collected from Canadian paediatricians and paediatric subspecialists via a one-time survey distributed by the Canadian Paediatric Surveillance Program in the fall of 2015. Descriptive analyses were conducted to determine the frequency of hesitancy, approaches to parent resistance and impact on clinical practice. A classification tree was generated to determine the most important predictors of physician-reported vaccine compliance. Results A total of 669 paediatricians completed the survey. Eighty-nine percent (n=588) of respondents indicated they had encountered hesitancy in their practice, with the top concerns including: Autism, too many vaccines, risk of a weakened immune system, and vaccine additives. The most common responses to parent resistance included discussing risks of non-vaccination, restating the vaccine recommendation and referring to reliable patient resources. Forty-five percent (n=301) of physicians indicated that hesitancy impacted their practice. Overall, the best predictor of physician-reported vaccine compliance was the use of a personal endorsement or anecdote (x2=6.955,df=1, adj.p< 0.01). Among physicians who did not use a personal endorsement, the next best predictor of vaccine compliance was spending 10 minutes or more discussing vaccination (x2=7.418, df=1,adj.p< 0.05). Conclusion This study contributes to a nascent body of literature related to paediatricians’ experience with vaccine hesitancy in a Canadian context, particularly as it relates to the impact of hesitancy on practice. This study demonstrates the ubiquity of hesitancy in clinical practice, the profound impact of hesitancy on paediatricians and highlights promising responses to parental hesitancy that may improve vaccine compliance. Future research should explore potential hesitancy interventions including using a personal endorsement and prolonged engagement using more rigorous methods of evaluation. Disclosures Kate E. Allan, PhD, Pfizer (Other Financial or Material Support, Postdoctoral Fellowship at the Centre for Vaccine-Preventable Diseases (at University of Toronto) is funded by Pfizer.)

Service-Learning in Audiology: A Systematic Review

2021 ◽  
pp. 1-12
Author(s):  
Alexis Ronney ◽  
Benjamin J. Kirby
Keyword(s):  
Service Learning ◽  
Best Practices ◽  
Outcome Measures ◽  
Student Outcomes ◽  
Student Attitudes ◽  
Future Research ◽  
Student Knowledge ◽  
Standard Scale ◽  
The Common ◽  
The Impact

Purpose Service-learning has the potential to improve student outcomes by providing students opportunities to apply their knowledge and skills in real-world contexts and is well suited to graduate education in communication sciences and disorders. However, relatively few service-learning studies in the literature focus on audiology, and the range of outcomes specific to audiology service-learning has not yet been characterized in a systematic way. The purpose of this critical review was to characterize the impact of service-learning on audiology students and clients/patients as evidenced by reflection activities and outcome measures, as well as to describe the common challenges and best practices in the available literature that may inform future research on service-learning in the field. Method A systematic search of the literature using multiple databases was completed according to standard guidelines. The impact of each study was evaluated using a standard scale of training efficacy. Study methods, including reflection activities and outcome measures, were recorded. Results Nine peer-reviewed studies on service-learning in audiology were selected. Six of the nine studies reported changes in student attitudes or awareness related to issues of clinical practice; five of the nine studies reported improvements in student knowledge/skills. Conclusions Overall, results of the review indicated benefits of service-learning to student clinicians. However, evidence for transference of service-learning benefits to organizational or departmental practice and benefit to patients/clients was lacking. Methodological limitations in the measurement of outcomes in prior works complicated evaluation of their impact; best practices were identified and synthesized for use in future research on audiology service-learning experiences.

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